WASHINGTON – About 10,000 veterans in Florida wait at least 90 days for access to Veterans Affairs medical centers around the state, the head of the VA health system that serves most veterans in the state said Thursday.

But Joleen Clark told House members from Florida her agency is taking aggressive steps — including frequent reviews of scheduling caseloads and “physician productivity” — to make sure veterans are seen as quickly as possible.

“I am happy to say access has been improving all throughout the year,” said Clark, network director of the VA Sunshine Health Care Network. “It is not where we want it to be... Our biggest concern is we don’t have the agility to grow fast enough to see all the patients.”

The network, known as Veterans Integrated Service Network 8 at the VA, is the largest of the agency’s 21 regional systems. Covering all of Florida except for the Panhandle area west of Tallahassee, it serves roughly 550,000 patients, or about one of every 10 enrolled in the VA system nationwide.

Thursday’s hearing before Florida’s congressional delegation comes amid growing rancor among congressional lawmakers and service organizations over lengthy wait times for veterans. Those delays may have contributed to some veterans’ deaths.

An internal VA audit released Monday found some 57,000 veterans nationwide reported waiting more than 90 days for first appointments, and 64,000 more said they were unable to get appointments at all.

The audit identified 112 VA medical facilities — including six in Florida — being investigated by the agency’s inspector general to determine whether they deliberately manipulated appointment schedules to make it appear veterans were getting medical treatment sooner than they really were. Some senior VA managers reportedly received bonuses for keeping caseloads down.

The six in Florida are: the Bay Pines VA Healthcare System in St. Petersburg, the Malcom Randall VA Medical Center in Gainesville, the Lake City VA Medical Center near Jacksonville, and outpatient clinics in Sarasota, Pensacola and Eglin Air Force Base near Pensacola.

Clark told lawmakers that officials from the inspector general’s office already have visited the medical centers in Gainesville and Lake City. Three employees in Gainesville were placed on administrative leave last month after auditors discovered that a list of patients needing follow-up appointments was kept on paper instead of in the VA's computer system. Clark said the three have returned but have been reassigned pending the outcome of the investigation.

Waiting times aren’t the only problem, Florida veterans say. They say the quality of VA medical care is uneven because of overworked doctors and a focus on processing caseloads rather than treating patients.

Jason Smith with the Florida chapter of the Veterans of Foreign Wars told lawmakers about a veteran who waited five months to see his primary care doctor after he was diagnosed with prostate cancer. And Robert McGuire, president of the state chapter of the Korean War Veterans Association, told lawmakers the VA conducted his annual physical over the telephone 18 months ago.

That’s one reason McGuire, 80, said he supports giving veterans more flexibility to get treatment at non-VA facilities, something that would be allowed under bipartisan bills passed this week by the Senate and the House.

“I love the VA because what they do well they do well, they do very well,” McGuire said. “But what they don’t do is timely medical care ... I would not be alive today if I relied on the VA.”

Clark said the VA often refers patients to private doctors if it’s warranted. About 10 percent of her VISN’s $4.4 billion budget last year was spent on private care, she said.

Smith there’s another problem: Thousands of Florida vets wait months just to find out if their disability claims have been approved. Only then can they enter the system for care as a disabled veteran.

“The recurrent story that we hear is that VA care is good — if you can get it,” Smith said.

Republican Jeff Miller, the Pensacola-area lawmaker who chairs the House Veterans’ Affairs Committee, told veterans that Congress will remain vigilant on the issue.

“Americans deserve an answer and veterans deserve nothing less than the truth and they deserve nothing less than the benefits that they have earned by wearing the uniform of this nation,” he said. “And this Congress will not rest until we have rooted out every single bad employee at the VA.”